Misc Drugs for Insomnia

[adder]

What about marihuana? If opioids and some strong benzodiazepines derivatives combos were suggested...

I mean seriously. I suffer from insomnia as well. And when I fall asleep finally, I end up waking up. It's a good thing I've got some science and history channels I can watch at night because I have probably already watched all movies HBO shows over and over. I don't use marihuana often but I do and it does help me. I take my evening dose of methadone and my evening dose of clonazepam and like 30 minutes later I smoke some weed. 2 hours later marihuana effects wear off and that's when I start to be sleepy.

Oh, I forgot to add that I've been taking benzodiazepines since 2004 every day and I've got a tolerance. My clonazepam is just to keep anxiety and seizures away. Sort of maintenance treatment that doesn't really exist for benzodiazepines...

It really should be legal, not everyone must use something that's legal. Do all people drink alcohol? I drink no alcohol, I like neither the taste of any alcoholic beverage or drinks and alcohol at all (even at clubs I ask for e.g. Sex on the Beach for drivers 8)) nor the high one gets after drinking like a few shots of vodka. I use snuff frequently and I smoke when I'm out (some stress related thing, I never smoke at home). Weed is good for a lot of things. I also have bad appetite and after weed, before I go to bed, I drink like 2 yogurts and eat something with a lot of kcals.

 

[redsweater]

drugs i have used for sleep and my opinions on them;
xanax - helped me sleep before i had a big tolerance, easily can knock you out in high doses but bad to use frequently if you are already using it at daytime for other reasons. if you are using it purely for sleep and maintain a stict dosage i think it could work
ambien - definately helps you sleep but also makes you feel wack (maybe just me)
oxycodone - accidently fell asleep a few times while nodding off, kind of a waste of oxy but gives a good sleep
mirtazapine - i got prescribed this as a "non-addictive" sleep drug even though its an antidepressant. worked very well but left me sleepy as fuck (kind of almost hungover) the next day... can't use it if you got work/uni
diphenhydramine - didn't help me at all really

 

[Elisa Dewen]

There's also Edluar (Ambien/zolpidem sublingual wafers). I think they're newish, as I just got some sample packets from my primary care doctor. For some reason, zolpidem never worked in pill form, and certainly not the lame low dose 12mg max CR tablet (which limited your dose to 6.5mg every 4 hours, whereas in IR form, the max recommended was 10mg).

I still have to take two of the Edluar 10mg sublingual dissolving tabs, but they hit you super fast. I need something that just will shut my brain off (I obsessively worry even when I try stuff like meditation) at night. I know sometimes the z-drugs affect people in strange ways, but people have reported similar behavior on all the hypnotic benzos, too. Not JUST z-drugs.

For the record, I have tried the following meds for sleep in my lifetime. Anything bold and underlined is something I currently use in my med rotation for sleep (all prescribed by a doctor):

Antidepressants (mostly TCAs):
Trazadone (didn't knock me out, just made me drowsy, and gave me migraines)
Amitryptilene (migraines)
Nortryptilene (migraines and didn't work)
Remeron/mirtazapine (made me super hungry and gained weight; at 12.5mg per night; worked for 2 days then it was like taking Benadryl only I always wanted to eat a lot and gained weight = not good when you smoke weed, too! )
Doxepin (currently taking - wow this is powerful at 25mg, I'd compare it to Remeron at 12mg.)

Benzos:
Restoril/temazepam (15-30mg not every night worked REALLY well for 2 years, but 30mg every night and it stopped working)
Dalmane/flurazepam (15-30mg, was quite effective, though very heavy and not usually recommended for long-term use);
Ativan/lorazepam (2mg - helped anxiety but didn't make me drowsy);
Xanax/alprazolam (am already prescribed it daily for panic attacks, don't use it much for sleep. XR version SUCKS, even brand);
Klonopin/clonazepam (take 2mg at night; certain generics are worthless aka Purepac and Ivax for me. Teva and Qualta work fine. This might help but I'd start at a much lower dose - I started with 0.25mg for insomnia; now I take the 2mg for anxiety and a Xanax PRN for panic attacks only)

Z-Drugs:
Ambien/zolpidem - already mentioned that IR and CR versions didn't work well, even at max recommended dosages. Edluar works (currently taking this but not every night), but I wake up after 2-3 hours unless I take 25mg Doxepin (just started for insomnia) or Phenergan (have a script for migraines, anti-nausea).
Lunesta/eszopiclone - not available in many countries outside the USA, from what I've heard. Caused the metallic/chlorinated taste in everything I eat/drink so I didn't try it beyond 2-3 days.
Sonata/zaleplon - kinda rare, I think, but I tried it. Woke up every 2-3 hours still, and had to use benzos to get back to sleep.


Antihistamines
Phenergan/promethazine - Yes this is actually a piperazine but it has antihistamine properties, and is a histamine receptor agonist. I get this for nausea related to migraines. It's also an antihistamine and in high doses is a weak Dopamine antagonist, but this is only used for nausea in the low dose ranges (25mg-50mg).
Doxylamine - 25-50mg, as long as it isn't taken for more than 2 days in a row, works nicely
Diphenhydramine - very weak and very ineffective (25-50mg, also tried going lower as that can be effective in this class of meds where higher doses start affecting Serotonin and other neurotransmitters), but works occasionally when I'm desperate, but I have to up the Klonopin dose to 3mg

I rotate my sleep meds about once every 2-3 days, using different combos (i.e. Klonopin + Doxepin for 2 nights, then Klonopin + Edluar/zolpidem + Phenergan/promethazine, then Klonopin 3mg/Diphenhydramine/Edluar/Xanax 1mg, then I'll stop Klonopin for about 3 days, adding Doxepin back in and using my hydromorphone, which I know is probably a no-no, but I only use it like 1-2 nights/week for sleep, and I get a script for it for 3 ruptured lumbar discs. I hope that made sense).

If I use any drug that affects the histamine receptors, they'll stop being as effective the more days in a row I take them. This just could be my weird genetic makeup though. Benzos will work for me longer, but if I keep a dose steady for over a week, I'll start needing more. So I rotate out Benzos occasionally, but I do need them for Panic Disorder and other major anxiety disorders which I won't bore people with since this is already a wall of text.

I tend to always use weed, also, which helps A LOT. Sometimes I can sleep on just a few bong hits and my Klonopin. Those are nice days.

Insomnia is a bitch. Hope you find something!

Also, Skullcap is an herb.
Other herbal stuff you can try include
Passionflower
Kava Kava (Gaia Herbs brand always works nicely for me, but is banned in Europe after some irresponsible manufacturers were harvesting the root too early and using too much root & stem instead of the actual plant). Still available OTC in the USA.
Kratom (over 5g, but be careful as this is opiate like and possibly habit-forming. I'd only use it as a rotating med if you're gonna try that)
Valerian Root (smells funky but works weakly on benzo receptors, but not considered addictive like actual benzos)
L-Tryptophan
Melatonin (doesn't work at all for me, after taking for 2 days straight, and even then, was very weak. Might work for others though).

 

[What was it?]

Hi guys. I've suffered from insomnia for several years now, but as of late it's been getting worse. 60mg of mirtazapine used to make me sleep. And while it still has sleep-inducing properties, it is no longer knocking me out the way it used to. I've tried a variety of benzos and have found one -- nitrazepam -- to have the desired hypnotic effect, from as little as 15mg. However, I'm paying exorbitant prices for this drug, so I can't really afford it for much longer. And, moreover, I don't want to become addicted to benzos.

What are some drugs -- OTC or otherwise (e.g. "natural" substances) -- which could give me a decent night's sleep? I'm getting sick of staying up till 4am and then waking up 4 or 5 hours later (that's without drugs). I NEED SOME SLEEP. Any suggestions are welcome.

Thank you!

Try and get some GHB perhaps. Really try and cycle off the benzos.....they will kill you if you use em for too long. I still prefer 15-20mgs of Valium for sleep if I DO have to use a benzo. Tried all others, nitrazepam ok as you said....triazolam is ok to fall asleep. Melatonin is a great idea and here is another tip...and FOLLOW this. Make sure your room is pitch dark before you sleep...no cracks, no LED lights. And make sure you are in a dimmed setting an hour before sleep and dont use electronics. Read, meditate. No exceptions!!! This should make the entire ordeal a lot better.....

 

[hmkey]

Nitrazepam 15mg is really a lot in my view.
I've had the problem too and benzo's Ive had a lot of them they don't really help for the problem really since you need more and more so really best for short term insomnia.
I take 50mg of Seroquel nowadays which works pretty good.
Compared to Nitrazepam, Seroquel (IR) its half life is even shorter then Nitrazepam, so you will wake up and you don't feel much of it anymore, except for the first couple of days.

 

[adder]

I will write only about the biggest disappointments for me and drugs that actually work for me. I won't mention anesthetics or similar drugs that work for me great but they're not to be used at home (e.g. ketamine, isoflurane, propofol etc.)

Green - good ones, little to no side effects
Red - they either don't work or they work but have terrible side effects
Orange - they didn't work me too well but they may be effective for some people

Concerning benzodiazepines, the only ones that worked hypnotic for me when I still didn't have a tolerance were: estazolam and midazolam. Later I also took triazolam, etizolam, and brotizolam but due to the fact I take clonazepam on a daily basis, I had to take large doses of brotizolam to get any hypnotic effect. Now I can take nitrazepam, nimetazepam, flunitrazepam - they all don't work hypnotically for me, nimetazepam and flunitrazepam are just as good as clonazepam in dose comparable in mgs to my clonazepam dose (i.e. 10 times as high dose of nimetazepam as clonazepam dose, and 2 times as high dose of flunitrazepam). It's impossible that someone sprinkled some date rape drug and raped me. lol

Zolpidem was always useless for me. To be honest at 10mg (I wasn't tolerant to benzodiazepines) I felt a very little bit of alertness. Zaleplon, zopiclone and eszopiclone were all of no use for me. I don't know how these Z-drugs can be helpful. Zolpidem has one apply - abuse... Besides all that, both zopiclone and (S)-zopiclone produce that metallic-like taste in mouth after ingestion.

Neuroleptics/anticholinergics/antihistamines:

These still knock me out. Levomepromazine is quite light, I mean without too much extrapyramidal side effects. Also, chlorprothixene doesn't have many extrapyramidal side effects but IME it's easier to kill oneself with these drugs than with opioids. I haven't taken phenothiazines or chlorprothixene for a long time now, I remember I had problems with breathing at effective doses and I felt like my mucous membrane in my nose was swollen so I couldn't inhale enough air through nostrils but it wasn't really that - the respiratory center was simply depressed - I also couldn't inhale through my mouth. So this is a problem...

Perazine is a very weak phenothiazine derivatives but I know it's unavailable in many countries. However, it doesn't really produce much noticeable side effects even at high doses and it's prescribed for problems with sleep to patients with benzodiazepine abuse present or patients prone to get addicted. It never made me sleepy, however.

Hydroxyzine made me breathe hard too at effective dose ( > 150mg). Otherwise it's alright, you can even sleep standing.

Promethazine may be a good one. It's actually prescribed off-label as a sleep aid in many countries and its official therapeutic index is just like other antihistamines for allergy. But it does boost opioids effects, it may be effective and it's not addictive.

(Dextro)brompheniramine/chlorpheniramine - these are used for sinus problems, often combined with pseudoephedrine. They are sleepy, I use dextrobrompheniramine to boost methadone effects (it has analgesic-sparing effects so it also boosts up pain-killing effects) so I can take a lower dose, it works (tidbit: brompheniramine led to invention of the first SSRI - zimelidine - and it itself has some SSRI properties).

 

[m314]

If the OP is not getting relief from a maximum dose of mirtazepine, and didn't benefit from seroquel or zyprexa, natural remedies won't do shit for him. No way. Maybe if he exercises daily, changes to a perfect diet, drinks lots of water, gets lots of sunlight and takes valerian and kava his ability to sleep will improve by like 1%.

I spent years trying just about every available pharmaceutical for sleep, including mirtazepine. You're wrong about natural remedies being ineffective, at least in my case. You're just not thinking of the right natural remedy.

Cannabis is by far the best herbal supplement I've tried for sleep. It beats every pharmaceutical out there, at least in my case. A small oral dose in the evening along with melatonin helps me sleep better than any benzo, hypnotic, atypical antipsychotic, or OTC sleeping pill. It's not perfect, but it does work and it keeps working over the long term.

 

[adder]

By treating marihuana as a herbal supplement, we might just go to a conclusion that opium poppy is the antidepressant. Herbs in medicine have been differentiated from plants containing active compounds for a long time now. By saying "herb" you may think of lemon balm, mint, nettle, etc.

At the same time I'm not negating that smoking weed helps fall asleep. I wrote about it myself but it's far from herbal supplementation. A lot of synthetic drugs have some analogs present in various plants from amphetamine-core and derivatives ones (in medicine: ephedrine and pseudoephedrine used worldwide, amphetamine and methamphetamine used in some places; black market: amphetamine and similar, methcathinone and similar, MDMA and similar, phenethylamines etc.) to morphine-core and derivatives ones (in medicine: morphine itself used worldwide and a lot of its derivatives; black market: mainly heroin but also a lot of medicines containing opioids abused). For those who believe in God it's a good excuse to use all these drugs. Cultivating and doing anything a man wants with plants growing on Earth is a common justification, right? 8)

 

[m314]

How is cannabis any less of an herbal supplement than kava or valerian, the two other herbs mentioned? If an herb has any effect on sleep at all, it contains active compounds. Taking one of my cannabis capsules for sleep is no different in spirit than taking a kava or valerian capsule, except mine actually works well. Cannabis as an herbal supplement, taken orally, has many other long term health benefits. Lower risk of cancer, heart disease, dementia, diabetes, obesity, etc.

I'm not one of those people who thinks "natural" automatically means good. Some natural drugs are good, some are bad. Same with synthetics. Some synthetic cannabinoids like jwh-018 work very well for sleep when taken orally. My only problem with that one is the short duration. If I knew how to make a time release jwh-018 capsule, I'd use that for sleep just like my cannabis capsules.

 

[adder]

You don't really have to be an advocate for cannabis here, it's not its use what I negate. I do use it as a sleep aid too sometimes but I don't think of it as a herbal aid and I know at that very moment I'm using a strong plant. And BTW I didn't mention kava kava, which has a light psychoactive effect, but that's another thing.

I,m not saying herbs can't be toxic but by your judging what is a herb any plant having a strong psychoactive effect on human brain would be a herb. Herbs (in medicine of course) are plants with some curing action on human body, not necessarily on CNS. This short definition would also make Papaver somniferum or Catha edulis herbs. But they're not. There's some culture and tradition involved in here, so I can't see opium poppy being mentioned in some pharmacognosy textbook as a herb. Traditional herbs are Ononis spinosa, Plantago lanceolata, Pulmonaria officinalis, Arctostaphylos uva-ursi, or Agrimonia eupatoria (I don't know common English names for these, well they probably even don't have ones knowing how much English borrows from Latin in science). Contrast effects of these plants with effects of Cannabis sativa, Catha edulis, and Papaver somniferum.

 

[m314]

You didn't mention kava, but my original post was responding to someone claiming herbs were useless for sleep compared to strong pharmaceuticals. He used kava and valerian as examples. I might be wrong about this, but I can't think of any herb out there that works for sleep without having a psychoactive effect. Kava, valerian, and cannabis are all psychoactive herbs.

I think we're just using different definitions for "herb". From the dictionary definition, any plant used as a medicine or flavoring is an herb. Having psychoactive effects doesn't make a plant any less of an herb. "Herb" and "drug" aren't mutually exclusive; in fact (I think) most herbs used as medicine are also drugs (or contain drugs, depending on how you look at it). I can walk into a GNC or Vitamin Shoppe today and find dozens of herbal supplements that are clearly psychoactive drugs. Kava, green tea, ephedra, yohimbe, guarana, rhodiola, wormwood, lots of others. Yes, even poppy is a medicinal herb and an herb used in flavoring. Daily poppy consumption isn't the best idea, though, except for people who really need it for pain.

Anyway, my original point was that herbs aren't automatically weaker or less effective than modern pharmaceuticals. I've tried just about every pharmaceutical for sleep, but in the end I found an herb that just works better without physical dependence or major side effects. It also has many long term benefits, as opposed to the harmful long term effects of some of the pharmaceutical drugs marketed for insomnia. I went through hell trying to get off Lunesta, for instance. At the time, it was claimed that Lunesta had no risk of physical dependence. The amount of pain that drug brought into my life was just completely unexpected. I feel physically ill now just seeing one of those commercials on TV. They openly advertise that garbage on TV here, but people still go to jail over a safe herbal medicine like cannabis.

 

[adder]

I wrote in my last post I had been referring to "herb" as a medicinal term. Otherwise it's "a plant whose stem does not produce woody, persistent tissue and generally dies back at the end of each growing season." (source) and by that definition marihuana is definitely a herb. Now referring to herbs as "plants used in medicine" again (well, here Cannabis sativa might actually be alright if only its use wasn't limited to some states of the US), these supposed to help fall asleep or calm down contain compounds that act on human CNS very lightly, geraniol is probably the best known example.

Sadly, I haven't had such good effects with herbs as you (medicinal herbs, I mean). I can drink an infusion of lemon balm only for its taste values. It never relaxed even a bit. But I can imagine how huge impact the fact I've started taking benzodiazepines at the age of 14 has on null effects from herbs. I don't mean marihuana here but I've never been a daily smoker and I've never had some passion to grow marihuana myself and process it into other forms so I don't have to inhale the smoke (not that I mind the smoke, I used to smoke quite a lot of cigarettes and even now I still smoke 2-3 cigs / day... I guess the problem is as a lab worker I don't have access to good weed since I lost contact for the good stuff from Holland but I'm sure I will sleep better when I arrive in London eventually %)).

 

[srs1980]

i take 75mg doxepin and it dont do squat for me. i seen in this thread that someone posted it was very strong, maybe as strong as remeron or something like that, but it just dont do the trick for me. anyways i take the doxepin and also take .5 mg clonazepam, propranolol, 150mg wellbutrin sr 2x a day, gabapentin 300mg at bedtime for back issues and nerve issues, and every now and then ill throw in like 25-50 mg of benadryl. nothing works and when i tell my doc that she just gives me this blank look like are you lying or do i have a patient with issues. ive tried trazodone all the way up to 300mg a night and it worked to get me to sleep but couldnt keep me to sleep but ive stopped that know because ive heard trazodone isnt something you want to take from quiet a few ppl on here. i guess the doxepin is mainly the sleep aid she thinks will work, because the clonazepam is twice a day but it doesnt say bedtime. anyone with any experience with the doxepin drug, i would be grateful if you would chime in and let me know what you think of it for sleep aid. and also wellbutrin sr......id like to know if its worked for ppl or is it just another "we'll have to wait and see if it works" drugs.

 

[kokaino]

The best "OTC" drug for insomnia has got to be diphenhydramine (Benadryl; Nytol, etc). Taking 50-100 mg is safe and effective. It takes a while for it to kick in (45-60 minutes), so don't fret if you aren't drowsy 30 minutes after taking it. The only other "OTC" meds I'd recommend are melatonin, valerian, kava kava and doxylamine succinate.

Other non-OTC drugs include so TCA antidepressants like amitriptyline. Others include antipsychotics like olanzapine (Zyprexa), risperidone (Risperdal), and especially quetiapine (Seroquel).

There are the nonbenzodiazepines or Z-drugs like zolpidem (Ambien) and eszopiclone (Lunesta).

But the best are the hypnotic benzo's. Nitrazepam and temazepam are great, so are lormetazepam, loprazolam and flunitrazepam.

You can even take higher doses of anxiolytics such as lorazepam (2 mg), oxazepam (45-60 mg), diazepam (20 mg), alprazolam (1-1.5 mg), or clonazepam (1.5-2 mg). I know clonazepam and alprazolam are equipotent but clonazepam does not have very strong sedative/hypnotic effects at doses of 1 mg or less.